Permit „ CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
- COMMUNITY DEVELOPMENT Permit#: FPS2021-00060
Date Issued: 10/28/2021
TIGARD 13125 SW Hall Blvd,Tigard OR 97223 503.718.2439 Parcel: 1S134DC00500
Jurisdiction: Tigard
Site address: 11476 SW TWIN PARK PL
Project: KURAHARA Subdivision: None Lot: None
Project Description: Fire sprinkler permit:A new NFPA 13D residential fire sprinkler system.
Contractor: RYANS PLUMBING Owner: KURAHARA,JORDAN
PO BOX 845 11476 SW TWIN PARK PL
BATTLE GROUND,WA 98604 PORTLAND,OR 97223
PHONE: 360-718-2415 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Misc Administration Fee 10/27/2021 $4.00
Permit Fee-COM 10/27/2021 $188.28
Type of Use: SF 12%State Surcharge-Building 10/27/2021 $22.59
Class of Work: ALT Type of Const: Plan Review-Fire Life Safety-COM 10/27/2021 $75.31
Occupancy Grp: R-3 Height: 15 ft Info Process/Archiving-Sm$0.50(up to 10/27/2021 $3.00
Stories: 2 11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required. No Hazard: LT
Density: 0.1 Design Area: 1500
K Factor: 05.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $293.18
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $10,067.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: Ha{,(,, vaw D¢.WZge„ Permittee Signature: Qvt,AY"I'"`c"z4- .Ovt,
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
i 6.1.'';'
cis
Building Permit Application
Fire Protection System r1l2(lil( I.. t I.t od 1
RECEIVE
[ Received
City of Tigard DateBY: NI/3i)) J�...O7_— Pcnnil No.: �=/JC-t;D;)) fA1)(0O
,s 13125 SW Hall Blvd.,Tigard,OR 97223 OCT7 Plan Review °l g� 'J J
Phone: 503.718.2439 Fax: 503.598.1960 V 2021 Da�gy: 1O- —�1�/ Other Pennit:�S% d)_co/0
t.1 C: it inspection Line: 503.639.4175 Date Ready/By:
✓✓✓ HI See Page 2 for
xT {� y.'11CrtiCt www•tigard-or'g°° CITY OF TIGARL ' ( Supplemental Information
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,11,E }'iT)IAix?-' `74 � 4,sb•' , -hi ZiitgAt_i!-:. '� .rr , 4***0F.ir. ,ti 4 •
New construction 0 Demolition Permit fees*are b�n the value of the work performed
Indicate the value(rounded to the nearest dollar)of all
Addition/alteration/replacement 0 Other:
equipment,materials,labor,overhead,and the profit for the
4::)31. z` t xs}tl �A --''/• y'�-pj: �'"v r �,; work indicated on this application.
sit ...t:t4 .�'. E w.:,,�..)i"dR. ..., •k.91,105 � ,,,b' Shs'k.5,,, .' /:
Ed I-and 2-family dwelling 0 Commercial/industrial Valuation: S 10, 0 6 7 . 0 0
0 Accessory building 0 Multi-family Number of bedrooms: 7
0 Master builder 0 Other:
Number of bathrooms: 3
`'y�"` p:g,Vii.,,�I.,#,C�.(�,t 1 �] ,iO4 � - lye '`t t,,' r`�-?�`} 3 Total number of floors: 2
q� �'4yi�Y`1�Ja'r.NY' t.)'Fr%N.ySI,Cf%-+:- Tc".i.a nw�S++... .-:`"tii'✓at'y..a7' ,�r<uT.��i��rM.t��ez4�":tis'
3 Job site address: 114-1ks 4a, 1►6 y\ Qtark bil New dwelling area: 2270 square feet
City/State/ZIP: 10, ,yi) Garage/carport area: square feet
Suitelbldg./apt.no.: Project name: � A� Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
'1C' a� Other structure area: square feet
"' f'e ti:;.T.;./',.'n'ro^,ir�.,4.•� •:+s 3+Mt.'• '---_..,,�•4.,•��
1 Subdivision:ecell 146 6,A\ nn I Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no: indicate the value(rounded to the nearest dollar)of all
"5fi .p/ A; ,o L f.,i , • 7t I /,M . .4 j equipment,materials,labor,overhead,and the profit for the
Ft.`,:�; a . r4 ._, + A+ yt7`rc' •� '...`�:`cl1, work indicated on this application.
/ u ,V%‘/CO V,\ C1C a IN ISO VitCgotiA y,4 Valuation: S
&)-tZ_ ��AAVAL�N Existing building area: square feet
kT New building area: square feet
` 1
- " '•i;i ii0.'"f it ,yr 4 ^a c*Tai Number of stories:
a
Name: � L,r V-0D� �YD� Type of construction:
Address: Occupancy groups:
c ,: City/State/ZIP: Existing:
.% Phone:( Q\.D-)Cg, Fax ( ) N/A New:
S�b-r -e--,t_r, Xf . .r tl~ 3 '•1' :rgh ,rF •=t: .ny?I F+•v' �y-,� r. r� '� , �- t
wax r ?ar .,,..�?r,t.>. .�,t ...;r :`.1 ';.kit' .`*•. «t 1`•a s' t r•-' rv.Z
Business name: 0 t xv- CAuvbor I All contractors and subcontractors are required to be
I Contact name: licensed with the Oregon Construction Contractors Board
Chi!1 ��' under ORS 701 and may be required to be licensed in the
Address: c-p can tt& i ., Pk)Qxwe, g,'},.I f. 22 jurisdiction in which work is being performed.If the
City/State/ZIP: \It'f��[\c m r i v U)p, (\f' 2 applicant is exempt from licensing,the following reasons
5I apply:
t" Phone:(` s()+))\\C�^21_115 Fax::( ) N/A
E-mail: UY�CI�Q'C� �11,,Q. eery.
-7 a ^tA`� �Ej .et r Fe;;-1• ,,-g„-Ukii4 �2:^�`3' S,00-4k t-p f, }'s',7 t • '`" `'-
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Business name: a�SJ\f \s ` \Vr it 1�Q ' Y S. Y:� .� rfl urr F. S,t�s M"'
'�—"�J�JJ►+'` ...III L Permit fee:
Address: PC N� tte?,ma _ �4 r 2 ,G State surcharge(12%of permit fee):
City/State/ZIP: v(3�`C Y UVeX w� ta -
FLS plan review(40%of permit fee):
"
Phone:(6�)''1,R` 1.1 jVo /Fax:( ) NIPS (Due upon application submittal.))
I •.h CCB lic.: ((%Z L III I�3 Total permit fees:
51 }' Amount received:
Authorized signature: (; This permit application expires Ifs permit is not obtained
r 1 0 0 5 2 0 2 within 180 days after It has been accepted as complete.
Print name: Ryan J ppe
cl,
Fee methodology set by Tri-County Building Industry
�' Date: Service Board.
N. ) 1:1Buiiding\➢ermiulFPS-Pm,itApp_031016.doc 4 0-46137(11101/COMIWEB)
4
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information •
Describe work to be done:
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
th+, New system Number of sprinkler heads: Number of alarm devices:
❑ Addition or ❑ 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and
Alteration (3)copies of sketch showing area (3)copies of sketch showing area
to existing of work within building structure of work within building structure
system
11+heads: Plan review required and ❑ 6+devices: Plan review required and
(3)sets of plans. (3)sets of plans.
Additional description of work:
\T\a\ck \fly n o. \QU 13D s`a LAA L --Q (\ V-\ )r c'o4e
Type of System (Complete A,B, C or D as applicable):
A.) Commercial Sprinkler 11. 1 p,
Sprinkler Type ❑ wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K.Factor
Sprinkler Project Valuation: 1 S
B.) Type I- Hood Fire Suppression System
Hood Project Valuation: S
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: individual Component ❑ Yes
Cur Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler(Stand Alone System) Q ;\1; (v �- ma.1- oo 101
Square Footage: Permit Fee:
0 to 2,000 S198.75
2,001 to 3,600
3,601 to 7,200 $310.05
7,201 and greater S404.39
Sprinkler Project Square Footage: 49.--1 0 sq. ft.
_a
Fire Protection Permit Fees
Project valuation subtotal (see A,B&C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage(see D above): $
State Surcharge (12%of permit fee): $
FLS Plan Review (40n/0 of permit fee): $
TOTAL: $
I:\Building\Pcmtits\FPS_PcrmitApp_O3I 01 G.doc 2